20CPMAR 1/16/2020
WARNING: If you purposely give false or misleading information on this worksheet, you may be fined, be sentenced to jail, or both.
Student Name ______________________________________ HCC ID: _________________________
Student Address: ______________________________________ City, St.: ________________________
What is your parents (or parent/step-parent) marital status as of today (check only one)?
Never Married Unmarried, both parents living together Separated
Married, or remarried Divorced, now single Widowed
Date your parents (or parent/step-parent) were married/remarried? * _____________________________
Date your parents (or parent/step-parent) were separated?
* _____________________________
Date your parents (or parent/step-parent) were divorced/widowed?
* _____________________________
* You may be required to provide documentation verifying the dates provided. *
Parent/Step-Parent Information: Full Name: ___________________________ Date of Birth: __________
Social Security Number: ______-____-______ Street Address: ___________________________________
Is this person Active Military Personnel? YES NO
If yes, where is this person stationed? __________________________________________________
Parent/Step-Parent Information: Full Name: ___________________________ Date of Birth: ___________
Social Security Number: ______-____-______ Street Address: ___________________________________
Is this person Active Military Personnel? YES NO
If yes, where is this person stationed? ___________________________________________________
IMPORTANT: If you would like to provide a statement to help explain the marital status circumstances,
please feel free to do so.
Each person signing this form certifies that all the information reported on it is complete and correct.
________________________________________________________ ____________________
Parent Signature Date
Student Financial Aid Office
11400 Robinwood Drive
Hagerstown, MD 21742
finaid@hagerstowncc.edu
FAX: 301-791-9165
Marital Status Form –
Parent(s)
Student Financial Aid Office
11400 Robinwood Drive
Hagerstown, MD 21742
Phone: 240-500-2473
finaid@hagerstowncc.edu
FAX: 301-791-9165
